Bioethics, as a field, seeks to think carefully about core human experiences. It deals with the “ancient human events of giving birth, suffering, dying, and caring,”[1] all while seeking a fuller understanding of what it means to be human in these common human experiences in the context of modern medical advances. In light of this, it is a core tenet of The Center for Bioethics & Human Dignity that bioethics should be made accessible to everyone. If, indeed, Benjamin Franklin’s words ring true that “in this world, nothing can be said to be certain, except death and taxes,” then at least one of the inevitable events of the human experience is within the purview of bioethical thinking. Further, many of the issues in the field sneak up on a person without warning; few of us genuinely prepare for the possibility of acute or chronic illness, infertility, or difficult end-of-life situations. That being said, it is a particular goal of the Center to be a resource for pastors as they walk with the members of their congregations through both the expected and unexpected of being embodied human beings in a world full of constant biomedical and, thus, bioethical change.
The previous director of the Center, Paige Comstock Cunningham, published an abbreviated account of her research on clergy awareness of health issues in Dignitas as a means of discerning the needs of pastors on bioethical issues. Thus, in an effort to make her excellent academic efforts more accessible to our pastoral audience, this piece will include direct quotations of her original findings interspersed with my own dialogue on the relevance of some of those findings for the Church.
In Paige’s own words,
The purpose of this survey, as part of my doctoral studies, was to assess pastors’ familiarity with a range of bioethical issues, the values and ethical frameworks they employ in resolving dilemmas, and the kinds of resources they rely on for help. Secondarily, respondents were asked their willingness to be interviewed for a future study that subsequently became the subject of my dissertation research. Analysis of the results of this online survey among pastors underlines the relevance of investigating what pastors know, their moral framework, and identifying their needs for credible bioethical resources.[2]
The need for an increase in resources available to pastors on bioethical issues was revealed by the fact that “most pastors received ethics training in seminary, but that does not necessarily correlate with exposure to bioethical issues they might encounter in congregational ministry.” Out of 31 institutions surveyed, only “thirteen seminaries offered electives that explicitly or plausibly included biomedical or bioethical issues.”[3] However, “beyond seminary training, some denominations provide guidance on bioethical issues. More than half of the respondents were aware of formal statements on bioethics issued by their denomination.”[4] Thus, denominations can care for the pastors within their networks by crafting carefully researched statements on bioethical issues with robust biblical, theological, scientific, and ethical content.[5] Denominational leaders can utilize pastors, biblical scholars, theologians, scientists, doctors, and ethicists within their congregations to craft guidance from which all churches within the denomination can benefit.
Either within such denominational circles or as individual pastors or groups of pastors seek answers to bioethical struggles, it may be wise to give priority to those issues their church leadership feels least equipped to deal with. The respondents of this survey “were most comfortable with counseling on marriage, death and grief, finances, and aging parents, followed by end-of-life medical decisions, addiction, and depression. They were least comfortable with addressing infertility.”[6] Another way to prioritize issues is to address those concerns most brought before pastoral staff:
The issues respondents had encountered (whether these were raised by members in their congregation was not determined) most frequently within the previous five years were cancer care (62%), drugs for a behavioral disorder (57%), chronic pain management (48%), care for the physically disabled (48%), and chronic disease management (46%) . . . A minority had been consulted on at least one issue of reproductive ethics: contraceptive use by married couples (30%), prenatal testing (23%), abortion for an unwanted pregnancy (21%), IVF (20%), abortion for reasons of the baby’s condition or health (16%), and artificial insemination by husband (15%).[7]
To address such issues, pastors and denominational leaders will need to be aware of the larger ethical frameworks within which ethical decisions are made. Regarding the use of such frameworks for bioethical decision-making,
the respondents were most supportive of a divine command or rule-based (deontological) ethical approach. They were least supportive of relativism, utilitarianism, or intuitionism (“listen to your inner ‘instinct.’”). A majority (59%) also objected to pure consequentialism (“The consequences of my actions are the most important factor for me to consider.”).[8]
Unsurprisingly, the pastors involved in this survey felt most comfortable utilizing a deontological ethical framework (“What ought I do?”). Indeed, out of the desire to keep Scripture as the greatest authority in the Christian life, we want to discern biblical rules that can be easily applied to our modern-day context. While such a desire is good, to remain in this space neglects one of the larger purposes for the “rules” laid out in Scripture: the transformation of the believer towards a greater love of God and of humankind (Matt 22:34–40; Gal 5:14). Such a love must involve right actions towards God and others (deontological ethics), but it also must transform the inner mind and heart of the doer into a lover of God and humanity, pressing him or her towards greater embodiment of Christian virtue such that application of the rules is done with wisdom and nuance (virtue ethics). If it matters at all that the Israelites were prohibited both from taking the belongings of their fellow Israelites (Ex 20:15) and from being the kind of person who is characterized by desiring such belongings (v. 17),[9] then character matters to matters of faith.
In my Dignitas article that explores the use of Scripture in bioethical decision-making, I affirm the approach of Linda Zagzebski’s Exemplarist Virtue Theory as a way to understand a key factor for practical virtue development.[10] For Zagzebski, “moral development is principally done by imitation,” with such imitation being driven by the emotion of admiration.[11] What this highlights is the necessity for relationally healthy churches in which admiration can flourish and imitation via discipleship is common practice. Thus, the church is better equipped to provide guidance on bioethical issues first by being the Church excellently. However, for this imitation process to produce virtue that disposes a person towards wise bioethical decisions, mentors must be equipped to understand the relationship between Christian virtue and bioethical issues.
Returning to Cunningham’s survey findings: “The majority of respondents agreed that access to information and knowledge about some health situations is valued.” Further, “the majority of respondents also agreed that scientific reasoning has a bearing upon ethical decision-making (73%) and that it is important for pastors to keep up on developments in medicine, technology, and science (93%).”[12] Yet,
despite their strong agreement with keeping up with developments in science, when asked to rank the relative importance of various resources in developing competence, formal training was ranked first by only 13%, and second by 6% of the respondents. Personal research or research conducted with others fared even worse, with only one respondent (<1%) ranking it first, and eight (6%) ranking it second.[13]
Instead, “almost equal numbers gave study of Scripture (34%, 49 respondents) or biblical worldview (35%, 50 respondents) highest priority. Overall, study of Scripture had the highest average ranking.”[14]
As a distinctively Christian bioethics center, we stand in agreement with a high view of Scripture, which places it as an orienting system for worldview development. Yet, as Kevin Vanhoozer states, Scripture is minimally what is needed to be saved and for the development of godly maturity, but it is not maximally the only source of guidance necessary for faithful Christian living.[15] Instead, both resources and academic fields outside of Scripture can continue “faith’s search for understanding.”[16] Thus, we affirm the goodness of formal training in bioethics for pastors and/or careful research either by individuals, pastoral groups, or denominational boards that involve not only Scripture but also such fields as theology, church tradition, science, medicine, philosophy, public policy, and ethics. We also hope that the resources CBHD provides via Dignitas, Intersections, The Bioethics Podcast, and our various other platforms will provide a bridge connecting the truth of Scripture, Christian virtue development, and wise bioethical thinking and decision-making for not only pastors but the people of the Church as a whole.
References
[1] Allen Verhey, Reading the Bible in the Strange World of Medicine (Grand Rapids, MI: Eerdmans, 2003), 40.
[2] Paige Comstock Cunningham, “Are Pastors Prepared? Results of a Survey on Clergy Awareness of Health Issues,” Dignitas 25, no. 2 (2018): 3, https://www.cbhd.org/dignitas-articles/are-pastors-prepared-results-of-a-survey-on-clergy-awareness-of-health-issues.
[3] Cunningham, “Are Pastors Prepared?” 4.
[4] Cunningham, “Are Pastors Prepared?” 4.
[5] In order to aid denominational leaders in this endeavor, here are some recommended CBHD resources that seek to answer the question of how to do distinctively Christian bioethics:
- Hans Madueme, “Thinking Theologically About Bioethics,” Dignitas 18, no. 3 (2011), 1, 3–5, 10–13, https://www.cbhd.org/dignitas-articles/thinking-theologically-about-bioethics-revisited.
- Scott Stiegemeyer, “Theological Anthropology for Bioethics,” Dignitas 30, no. 1 (2023): 13–21, https://www.cbhd.org/dignitas-articles/theological-anthropology-for-bioethics.
- Anna Vollema, “Equipped for Every Good Work: The Use of Scripture in Bioethical Decision Making,” Dignitas 30, no. 1 (2023): 4–12, https://www.cbhd.org/dignitas-articles/equipped-for-every-good-work-the-use-of-scripture-in-bioethical-decision-making.
- John Kilner, ed. Why the Church Needs Bioethics: A Guide to Wise Engagement with Life’s Challenges (Grand Rapids, MI: Zondervan, 2011). You can read Nathan Barczi’s Intersections review of this book here.
- Robert D. Orr, Medical Ethics and the Faith Factor: A Handbook for Clergy and Health-Care Professionals (Grand Rapids, MI: Zondervan, 2009).
CBHD will soon be putting out a 30th anniversary celebration eBook of Dignitas that covers foundational issues for bioethical decision-making, along with representative topics from key bioethical figures throughout the history of our academic publication.
[6] Cunningham, “Are Pastors Prepared?” 4.
[7] Cunningham, “Are Pastors Prepared?” 4.
[8] Cunningham, “Are Pastors Prepared?” 4.
[9] The Hebrew term Chamad means to “desire” or “take pleasure in” in an ungoverned and selfish manner. Thus, there is a difference between merely a fleeting desire for a nice house and an obsessive, controlling desire born out of selfishness. While less relevant to this passage, it is also notable that the Greek term used for “to lust” (epithumeo) similarly denotes an obsessive desire upon which one sets their heart.
[10] Note that in this piece, I mainly use her book (Exemplarist Moral Theory, 2017) directed at a more secular audience. However, Zagzebski has written a book entitled Divine Motivation Theory (2006) that explores how God functions as a moral exemplar in his motivations. Due to the philosophical nature of this second book, I chose her more practical book for such a short essay. Zagzebski herself suggests an integration of these two resources. See “Divine Motivation Theory and Exemplarism,” European Journal for Philosophy of Religion 8, no. 3 (Fall 2016): 109–21, https://doi.org/10.24204/ejpr.v8i3.1689.
[11] Linda Zagzebski, “Exemplarist Virtue Theory,” Metaphilosophy 41, no. 1/2 (2010): 51–52, https://doi.org/10.1111/j.1467-9973.2009.01627.x.
[12] Cunningham, “Are Pastors Prepared?” 7.
[13] Cunningham, “Are Pastors Prepared?” 7.
[14] Cunningham, “Are Pastors Prepared?” 7.
[15] Kevin Vanhoozer, “The Sufficiency of Scripture: A Critical and Constructive Account,” Journal of Psychology and Theology 49, no. 3 (2021): 219, https://doi.org/10.1177/0091647121995836.
[16] Vanhoozer, “The Sufficiency of Scripture,” 230.